Metabolic Syndromes as Important Comorbidities in Patients of Inherited Retinal Degenerations: Experiences from the Nationwide Health Database and a Large Hospital-Based Cohort

Guann-Jye Chiou, Ding-Siang Huang, Fung-Rong Hu, Chung-May Yang, Chang-Hao Yang, Ching-Wen Huang, Jou-Wei Lin, Chao-Wen Lin, Tzyy-Chang Ho, Yi-Ting Hsieh, Tso-Ting Lai, Ho-Min Chen, Pei-Lung Chen, Chuhsing Kate Hsiao and Ta-Ching Chen
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Guann-Jye Chiou: Department of Medical Education, National Taiwan University Hospital, Taipei 100, Taiwan
Ding-Siang Huang: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Fung-Rong Hu: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Chung-May Yang: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Chang-Hao Yang: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Ching-Wen Huang: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Jou-Wei Lin: Cardiovascular Center, National Taiwan University Hospital (Yun-Lin Branch), Yunlin 632, Taiwan
Chao-Wen Lin: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Tzyy-Chang Ho: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Yi-Ting Hsieh: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Tso-Ting Lai: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan
Ho-Min Chen: Health Data Research Center, National Taiwan University, Taipei 100, Taiwan
Pei-Lung Chen: Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
Chuhsing Kate Hsiao: Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
Ta-Ching Chen: Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan

IJERPH, 2021, vol. 18, issue 4, 1-15

Abstract: This study aimed to evaluate the medical and socioeconomic impacts of IRDs using the nationwide health database and a large hospital-based cohort. This retrospective cross-sectional cohort study used data from the nationwide National Health Insurance Research Database (NHIRD). All patients with IRD from January 2012 to December 2016 were selected from the NHIRD and matched with the general population at a ratio of 1:4. All variables, including comorbidities, medications, service utilization, and medical costs, within 1 year from the date of the IRD diagnosis, were analyzed. Disability data were retrieved from the Taiwan Inherited retinal degeneration Project (TIP), a medical center-based database. A total of 4447 and 17,788 subjects from the nationwide database were included in the IRD and control groups, respectively. The Charlson comorbidity index score was higher in the IRD group (0.74:0.52, p < 0.001). Yearly visits to the ophthalmology clinic were more frequent in the IRD group (6.80:1.06, p < 0.001), particularly to tertiary medical centers ( p < 0.001). The IRD group showed greater odds ratios (OR) for metabolic syndrome-related comorbidities, including hypertension (OR = 1.18, 95% confidence interval (CI) 1.10 to 1.26) and diabetes (OR = 1.32, 95% CI 1.21 to 1.45), and double the average yearly medical cost (2104.3 vs. 1084.6 USD, p < 0.001) and ten times the yearly ophthalmology cost (369.1 vs. 36.1 USD, p < 0.001). The average disability level was 54.17% for all subjects. This study revealed the large medical and socioeconomic impacts of IRD on not only patients with IRD, but also their family members and the whole society.

Keywords: inherited retinal degenerations; socioeconomic impacts; Charlson comorbidity index; metabolic syndrome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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